一氧化氮吸入联合高频振荡通气治疗新生儿重度呼吸衰竭

Inhaled nitric oxide combined with high frequency oscillatory ventilation in the treatment of neonates with severe respiratory failure

目的探讨一氧化氮吸入联合高频通气治疗新生儿重度呼吸衰竭的临床效果。方法 2011年2月至2013年12月我科用一氧化氮吸入联合高频振荡通气治疗新生儿重度呼吸衰竭38例,男27例,女11例,观察治疗前和治疗后1、6、24 h的血气分析、氧合指数(OI),动脉肺泡氧分压比值(a/A),监测治疗效果及副作用。结果所有病例PH、PaCO2、PaO2、OI、a/A在治疗后1、6、24 h均较治疗前改善(P均<0.01),治愈28例(73.7%),因病情危重放弃治疗及死亡10例(26.3%),未发现高铁血红蛋白血症。结论一氧化氮吸入联合高频振荡通气治疗重度呼吸衰竭是安全和有效的,值得临床推广。

Objective To explore the efficacy and safety of nitric oxide inhalation combined high-frequency oscillatory ventilation in the treatment of infants with severe respiration failure. Methods 38 infants with severe respiration failure were treated with nitric oxide inhalation combined with high-frequency oscillatory ventilation. Their blood gas,oxygenation index（ OI）,arterial alveolar oxygen tension ratio（ a /A）,clinical efficacy and side-effect were compared before and 1,6,and 24 hours after the treatment. Results The levels of PH,PaCO2,PaO2,OI and a /A of 38 infants were all improved 1,6 and 24 hours after the treatment（ P 0. 01）. 28 cases（ 73. 7%） were cured,and 10（ 26. 3%） died of seriously ill. Methemoglobinemia was not found. Conclusion Nitric oxide inhalation combined with high-frequency oscillatory ventilation is safe and effective in the treatment of infants with severe respiratory failure.